Are care cooperatives a new model for integrated care?

Maybe you have had similar experiences: My 89-year old mother lives 550 kilometres away, she wants to stay in her house where she has been living for over 50 years, but needs a lot of help. The necessary services are available, but who is there to coordinate medical care (doctor, pharmacies, nurses), cleaning, shopping, transportation, financial tasks, communication with friends and family as well as voluntary help organisations, etc.? It is nearly impossible to organize all this from the distance. Furthermore my family is only one of millions in Europe facing the same challenge.

The increasing number of people in Europe with chronic diseases and the obstacles their families have to overcome in their task to coordinate the needed services lead to the urgent search for new models. Different models have been developed in the past years in healthcare, e.g managed care. But their focus was mainly set on cost control and the coordination of medical services. In Switzerland voters refused the managed-care model in a ballot. Seniors, families and communities are looking for alternatives. The idea to form cooperatives has become popular. What if we could bring both sides together and take the next stepto healthcare 4.0?

Healthcare of the future – what should it be like?

Otto Scharmer, Senior Lecturer at MIT in Boston, is the author of “Theory U” and co-author of “Presence and Leading from the Emerging Future” (see this article of the Presencing Institute). He describes the development of healthcare from 1.0 to 4.0 as following:

Input- and authority centred, institutional care

Outcome-centred managed care

Patient-centred integrated care

Citizen-centred, holistic and comprehensive care

In Europe we are now on the threshold to 4.0. Cooperatives could have a key role in realizing this next step.

What is my idea of the future chronic care in a care cooperative? My family as a cooperative member would know that all the services my mother needs are coordinated from a single source. All information on health, medication, services and
support for daily living are stored centrally. Access is given only to the provider needing it. If something unplanned happens – as it does all the time – the cooperation takes care of transportation to a doctor, for example, or organizes someone to look after the garden. If new needs are coming up in the community, as for example barrier-free apartments, the cooperative will see to it. As members of a multi-stakeholder cooperative we will have a voice in the democratic decision-making process and can be sure that our interests will be heard.

Is this concept unrealistic?

Absolutely not. Even if there are only a few care cooperatives in Switzerland and Germany we can see that in other countries like Italy, France and the Netherlands these institutions work successfully and are important social enterprises. We can learn from existing care cooperatives and found new ones in our country.

iCareCoops will support the founding and management of a care coop by providing information, an Internet platform with different tools and an app for easier communication and organisation.

Are you interested in bringing the idea forward?

At the 13th Congress of Swiss Health Economists and Health Scientists on 21st of October in Berne, Switzerland, I presented these ideas in a speech and discussed them with experts from different professions. There are also communities and other health professionals supporting the idea of care cooperatives in Switzerland. We would like to gather these people and discuss the next steps to be taken.